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Form for issurance of duplicate share certificates - Punjab National

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					                                                                                Annexure – I
                              PUNJAB NATIONAL BANK
                               (Name & Address of RTA)
                                    MCS Limited
                                 F-65, Okhla Industrial Area Phase – I
                                          New Delhi – 110 020
                                    Tel. No. Direct – 011-41709884
                                    EPABX – 011-41406149/51/52
                                         Fax No. 011-41709881
                                      e-mail: admin@mcs.del.com

                                      Questionnaire Form
(Format to be filled in by applicants(s) for issue of duplicate share certificate(s) in lieu
of share certificate(s) lost / destroyed)
   1.  Registered Folio No. (if any)
   2.  Full name of holder and joint holder(s), if
       any, (Full in identical order)
   3. Number of shares
       (In figures)
       (In words)
   4. Distinctive number of shares
   5. Certificate numbers
   6. Date of acquisition of shares
   7. Mode of acquisition of shares
   8. Date when the certificate(s) lost or found
       missing
   9. Full statement of the circumstances
       regarding loss of certificate(s) (Annexure
       sheet if space is not sufficient)
   10. Whether signed transfer deeds were also
       accompanying the lost certificates. If
       answer is yes, prohibitory order of a
       competent court restraining bank from
       registering transfer in the name of any
       other person, on the basis of such transfer
       deeds, if obtained, be also furnished.
   11. Whether the shares were pledged, if yes,
       give full particulars.
   12. Signature of Holder(s) (as available in the          1.
       record of Bank, if furnished earlier)
                                                            2.

                                                            3.
                                                                          Annexure – II

                                                            To be stamped as an
                                                            Affidavit as prescribed under
                                                            local law

                                    AFFIDAVIT

I/We*

                                                                           do solemnly

affirm and state that the facts stated in the annexed Questionnaire Form are true to my /

our knowledge and belief.


                                                                            Deponent(s)


I/We* above named deponent(s), hereby declare and verify that the aforesaid facts

are true to the best of my / our knowledge and belief.

Signed and verified at                   this the        day of           _ 20     .



                                                                            Deponent(s)

*(State name, father/husband’s name and address of deponent and all deponents, if more
than one)
                                                                            Annexure – III

                                                     To be stamped as an Agreement (if
                                                     not witnessed) and as Indemnity
                                                     Bond (if witnessed)


                                         INDEMNITY


This Indemnity is issued at                                  on this the            day of
                      , 20     by
(hereinafter called the ‘holder(s)’ which term shall, unless repugnant to the context,
include my / our successors and assigns) in favour of Punjab National Bank, a body
corporate constituted under the Banking Companies (Acquisition & Transfer of
Undertaking) Act, 1970, having its Head Office at 7, Bhikaji Cama Place, New Delhi,
hereinafter called the “Bank” which expression shall, unless repugnant to the context,
include its successors and assignees.

WHEREAS, I/We, the said holder(s), am/are the holders of                    shares of the
Bank comprised in the Share certificate No.                 bearing Distinctive Nos. from
                 to                  .

WHEREAS, I/We, the said holder(s), have not sold, disposed of, pledged, or otherwise
encumbered the said shares, or parted with the possession of the said share certificate(s)
since the date of my/our becoming the lawful owner(s) of the said shares of the bank.


WHEREAS, the share certificate(s) in respect of the said shares have been lost/
destroyed/have not been received by me / us / misplaced in transit, and I / We, the said
holder(s), have applied to the bank for issuing duplicate share certificate(s) in lieu there
of.

NOW THIS INDENTURE witnesseth that in consideration of bank issuing duplicate
share certificates on my/our said representation and request, I/We the said holder(s), do
hereby, jointly and severally, undertake to save and defend the bank and to keep the
bank harmless and indemnified at all times and from time to time, against all losses and
damages and actions, causes, suits, proceedings, claims and demands of any person(s)
whatsoever, arising as a result of issuing duplicate share certificates by bank to me/us.


I/We, the said holders, further undertake on demand by the Bank, to return and re-deliver
such duplicate share certificate(s) immediately to bank without demur and protest.


I/We, the said holder(s), also undertake to return to the bank the original share
certificate(s) when found and traced, and to take all actions, including suits and
proceedings, at our cost, as the bank shall require for the recovery thereof.


I/We, the said holders have accordingly signed these presents on the day, month and
year mentioned here in above.


                                                                         EXECUTANT(S)
                                                                           Annexure – IV
                                                    To be stamped as an Agreement (if
                                                    not witnessed) and as Indemnity
                                                    Bond (if witnessed)
                               INDEMNITY WITH SURETY
This Indemnity is issued at                               on this the             day of
                        , 20     by
(hereinafter called the ‘shareholder(s)’ which term shall, unless repugnant to the context,
include his/her/their     successors and assigns)     and
                                          &                                      (both of
them hereinafter called the ‘sureties’ which expression shall, unless repugnant to the
context, include their respective successors and assigns) in favour of Punjab National
Bank, a body corporate constituted under the Banking Companies (Acquisition &
Transfer of Undertaking) Act, 1970, having its Head Office at 7, Bhikaji Cama Place,
New Delhi, hereinafter called the “Bank” which expression shall, unless repugnant to the
context, include its successors and assignees.

WHEREAS, the said holder(s), is/are the holders of                    shares of the Bank
comprised in the Share Certificate No.                      bearing Distinctive Nos. from
                 to                   .

WHEREAS the said shareholder(s), has/have not sold, disposed of, pledged, or
otherwise encumbered the said shares, or parted with the possession of the said share
certificate(s) since the date of becoming the lawful owner(s) of the said shares of the
bank.

WHEREAS, the share certificate(s) in respect of the said shares have been lost/
destroyed/have not been received by the said holder(s) / misplaced in transit, and the said
holder(s) has/have applied to the bank for issuing duplicate share certificate(s) in lieu
there of.
NOW THIS INDENTURE witnesseth that in consideration of bank issuing duplicate
share certificates to the shareholder(s) on the representation and request of the said
shareholder(s) and sureties, the said shareholder(s) and the sureties, do hereby jointly
and severally, undertake to save and defend the bank and to keep the bank harmless and
indemnified at all time and from time to time against all losses and damages and actions,
causes, suits, proceedings, claims and demands of any person(s) whatsoever, arising as a
result of issuing duplicate share certificates by bank to the said shareholder(s).


The said shareholder(s), further undertake(s) on demand by the Bank, to return and re-
deliver such duplicate share certificate(s) immediately to bank without demur and
protest.


The said shareholder(s), also undertake(s) to return to the bank the original share
certificate(s) when found and traced, and to take all actions, including suits and
proceedings, at his/her/their expense and cost, as the bank shall require for the recovery
thereof.


The said shareholders and the sureties have accordingly signed these presents on the day,
month and year mentioned here in above.




                               1. Shareholder(s)


                               2. Surety (ies)


                                                                          EXECUTANT(S)

				
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